A N N UA LR E P O R T

2014

E N T E R

© Medic Mobile, 2014 Annual Report We are all health workers

Partnered with 15 new organizations around the world

Scaled to 400 health workers with Christian Aid in Kenya, supporting antenatalcare

Helped nine new pharmacies track medicine with HealthRight International inKenya

Won the Skoll Award for Social Entrepreneurship

Equipped 750 household caregivers for adherence support with KEMRI and theWellcome Trust in Kenya

Launched our first program to screen for mental illness with the MINDS Foundationin Vadodara, India

Piloted antenatal care coordination with the Saving Mothers Project inTanzania—applied for and won significant HDIF grant funding to scale in

September 2015

Equipped 50 new health workers with Makueni District Ministry of Health forimmunization coordination, service reporting and antenatal care

Created the first Do It Yourself version of Medic Mobile for Antenatal Care

Equipped 50 new health workers to track disease outbreaks with UnitedMethodist Communications in the Democratic Republic of the Congo

Launched our first program for educational messaging with 50 householdcaregivers, focused on improving clubfoot treatment adherence with miraclefeet in

Mumbai, India

Female Community Health Volunteers in Nepal harness mobile technology throughpartnership with One Heart World-Wide

Worked with Nexleaf in Kilifi, Kenya to keep medicines at safe temperatures in42 hospitals

Supported stock monitoring with 408 new clinics with IntraHealth in Senegal, andplanned for national scale-up by the end of 2015

Developed dashboards to support monthly performance reviews with communityhealth workers and their supervisors with Muso in Mali

Highlights

© Medic Mobile, 2014 Annual Report We are all health workers

I remember the first time I met a patient who had been carted over 50 miles along adirt road. She was waiting to see the one doctor at the one hospital in her area. I amstill unsettled by the reality of healthcare access in many last-mile communities, but Iam far more optimistic than I was when we began our work in 2009.

Here’s why.We have seen what happens when community health workers can communicate with a support teamabout potential illnesses. The number of patients treated for tuberculosis at a hospital in Malawidoubled within six months.

We have seen the impact of disease surveillance teams tracking outbreaks 100 times faster thanbefore. Speed matters in global health, and connected systems are more resilient.

Finally, we have seen what it looks like when essential care reaches more people. In one area of peri-urban India, 30% of children weren't receiving the vaccines they needed. A simple registration andreminder system increased immunization rates to 97%.

The backbone of these systems is a network of community health workers. The results hint at what thefuture will look like if we connect and support them. That's our job. Medic Mobile builds mobile andweb tools for health workers in the hardest-to-reach communities. We know that systems can workbetter for people, and we know that we can save more lives.

Powered by solar panels, mobile tools guide community health workers as they look after the health oftheir neighbors. Every pregnancy and birth can be tracked, creating schedules of care shared withstaff at the nearest health facilities. Nurses get updates and alerts from home visits in remote villages.Trainers target their efforts and use performance dashboards during coaching sessions. Informationabout health services, drug stock levels, and disease burdens for thousands of communities is availablein near-real-time.

By the end of 2014, we were supporting over 8,000 health workers serving a million families. Withina year, our team grew significantly, our technology toolkit was transformed, we deepened ourunderstanding of high-impact use cases, and we explored new impact areas. Medic Mobile reachedmore health workers and communities than any previous year. This would not have been possiblewithout a committed and talented team, innovative partners working towards a better world, andsupporters who empower us to focus on our mission. We are proud of the progress in 2014, and weknow we have a lot of work ahead of us.

When the very first group of community health workers gathered for phone training, a woman namedVerona said,

"This must succeed, for our communities and communities like ours."

That quote stuck with me. For us, achieving scale is an act of solidarity. By 2020, we need to get ourtools into the hands of 200,000 health workers to support them as they provide care, door to door, for100 million people.

We need to get the best tools to every health organization and every clinic on the planet that needs them– especially those that are small, remote, and under-resourced. To do this, we built a self-service, Do-It-Yourself version of Medic Mobile.

We believe that health is a human right and everyone is worthy of moral concern. To reach everyonewith better care, we need to redefine who a health worker is, rethink where they provide care, and putthe right technology in their hands. Together, we can get there.

We can create a world we are proud to live in today and that wewould wish anyone, anywhere to be born into tomorrow.

– Josh Nesbit, CEO

MessageFrom Josh

© Medic Mobile, 2014 Annual Report We are all health workers

Since 2010, Medic Mobile's product team has developed technology designedspecifically for health workers in remote and challenging environments. Wepioneered the use of SIM card applications for healthcare, enabling any basic phoneto run applications for health workers. We also built applications that enable real-timecommunication between community health workers and their support teams. In thepast year, our toolkit for health workers evolved significantly.

New versions of our web app for nurses and managersUsing our web app, clinical teams and managers can view near-real-time updates from health workersand families in their catchment area, exchange messages with their contacts, schedule automatedreminders and alerts, and use analytics and visualizations to improve health services. Our web app isdesigned for the realities of hard-to-reach health facilities, even if they are entirely offline. We'vetransformed our web app in the past year, adding a new and improved user interface, more powerfulfilters, an easier way to organize people and places, and better export and integration options. Weare proud to deliver the new Medic Mobile web app for nurses and managers, helping them manageequitable health systems.

Earlier Version of Medic Mobile Web App

New version of the web app

Medic Mobile's first Android appAs smartphones became more accessible, we recognized the opportunity to harness low-cost Androiddevices to support frontline health workers. We recently released Medic Mobile's first Android app,which is fully integrated into our toolkit. The app includes easy-to-use forms with skip logic, locationdata, in-app data validation, and multimedia support. Health workers or managers can submit data bymobile internet, wifi, or SMS as a backup. Medic Mobile's Android app is based on ODK Collect, anopen-source tool, and can easily be configured for specific projects. The forms and settings can beupdated in the field, and the app will notify health workers when reports need to be submitted. Healthworkers are able to register people into health programs, screen for high-risk pregnancies, submit stockreports, report disease outbreaks, and more.

Better management tools for community health systemsOver the past year, analytics tools have become central components of Medic Mobile's programs.We have seen the power of providing visibility into performance of health workers and outcomes inhealth systems. Working alongside partners, we designed dashboards to show high-priority data todrive immediate action to improve the care of patients, as well as long-term trends to inform programdesign and management. We built out new views for decision-makers, giving them access toindicators and timely alerts, such as how many facility-based births occurred in the last month.

Introducing the "Do It Yourself" packageMedic Mobile is now able to offer our software as a free, do-it-yourself download for community-based organizations, NGOs, and public and private health facilities. Our goal is to make our besttools accessible to the smallest organizations working in the most challenging settings. To do this, wepackaged years of experience using Medic Mobile for antenatal care into an easy-to-use,downloadable application. The DIY package is free, and the software works offline on a localcomputer. Starting this year, organizations can use the DIY package to register pregnancies, trackantenatal care, and increase facility-based deliveries.

Better Tools

Our delivery model

In 2014, we reflected on our goals for achieving both scale and reach. In order for us to fulfill ourmission, we need to equip a large number of health workers as well as those who are hardest to reach.Medic Mobile's tools must be accessible to any impact-driven health organization, regardless of theirsize or resources. This reflection led to a new way to deliver Medic Mobile. In 2014, we created a self-service version of our offline web application and the first Do It Yourself (DIY) package.

Our Do-It-Yourself (DIY) package for antenatal care coordination is now available atmedicmobile.org/diy. It's the easiest way for NGOs and clinic staff to learn about and implement ourANC tools. In addition to an easy-to-use web application with a setup wizard and product tour, our DIYpackage now includes a cost estimator to help with budgeting, suggestions for participatory designmethods, a step-by-step implementation guide, reference guides for community-based and facility-basedusers, and an impact monitoring framework. Using Medic Mobile, health workers can registerpregnancies in their communities, receive automated SMS reminders about upcoming appointments,report danger signs and communicate with managers and teams at clinics.This year, we released the first private beta version of our DIY package for ANC. Hundreds of usersaround the world including NGOs, community-based organizations and IT consulting firms haverequested downloads. We are working with this initial cohort of users to identify improvements to bemade in order to prepare Medic Mobile for ANC for public beta release in 2015. Through a series ofuser testing sessions, structured feedback discussions and follow-up visits we will improve Medic Mobileand develop additional materials to ensure that our DIY users can deploy successfully.

Our goals for 2015 are to build a strong DIY team that will ensure high-quality software, support DIYusers, manage community resources, lead user testing and organize feedback, run training workshopsand work with channel partners. The team will be developing expanded training materials, including auser guide, which will cover project planning, deployment and monitoring, as well as a cost estimatorand additional help documents to support users as they are learning to use Medic Mobile. Using thesematerials, we aim to bring 20-30 users on board with successful ANC deployments and conduct follow-up visits to monitor the impact of their programs.

Our Products and Use Cases

Medic Mobile supports a wide range of health workers, from community health workers to nurses toMinistry of Health officials. They're all performing an essential role in delivering healthcare and they allneed different information. Our team is now focused on making Medic Mobile accessible and helpful fora new level of the health system: community health worker supervisors. These are largely non-clinicalmanagers who ensure that community health workers (CHWs) are effectively performing their duties.

We learned that CHW Supervisors have very different needs for a dashboard than a clinical nurse.Ongoing support and refresher trainings are required by CHWs who are using mobile phones to reporton their activities. We sought to understand these supervisors and develop a persona and dashboarduser stories tailored to their needs.

Our Africa Regional Designer put together a snapshot of Ann's life as a Community Health WorkerSupervisor. We use these detailed narratives to design our products.

80% of Ann's time is spent interacting with the community and the CHWs. This month's meeting with theCHWs is early next week. She must make some time to prepare some notes on how to make drinkingwater safe for use in the community. During a visit in the community, she observed that the communitywas using unsafe water for drinking and the CHW did not know what to advise her households to makethe water safe. The CHW Supervisor continues to offer need-based training to the CHWs depending onassessment of the knowledge deficits of the CHWs. She guides the CHWs on how to effectivelycommunicate well with the community. She guides the CHWs on the data items to collect. As a CHWSupervisor, she is charged by the Ministry of Health to aggregate data about the community's health thatis received from the CHWs on a monthly basis. The primary data items for her reflect the utilization ofhealth services by the community.

Ann's needs include:1. Accurate data from the CHWs2. Send reports to district supervisors promptly3. Mobilize CHWs regularly and lead them on targeted community health activities4. Closely monitor the progress of each individual CHW and provide guidance to the CHWs who

need support5. Motivate the CHWs consistently so that they do not drop out of doing the community service, as

the CHWs work purely as volunteers

With this information, we built dashboard views highlighting CHW activity across a number of metricswhich let Ann know how well her CHWs are performing. As a result of this increased supervision, weanticipate that the quality of the services that CHWs provide will improve, translating to a greater numberof women receiving ANC and children completing their immunizations.

Learnings

© Medic Mobile, 2014 Annual Report We are all health workers

© Medic Mobile, 2014 Annual Report We are all health workers

Strong partnerships are fundamental to our ability to reach more health workers.We're in awe of every one of our partners and celebrate their dedication andingenuity. It's a privilege to combine our technology and our learnings to work withpartners to reach even more communities.

Kilifi Kids, Makueni District, KenyaMedic Mobile and Kilifi Kids, an NGO dedicated to improving maternal and child health in Kenya,have been working together since 2009. After our first pilot in Kilifi we saw monthly facility-baseddeliveries more than double from the previous year (pilot data by Medic Mobile, 2013). We've nowbrought our antenatal care and immunization tools to 50 new health workers in the Makueni District.

Nexleaf, KenyaMedic Mobile and Nexleaf Analytic's ColdTrace are now tracking temperatures of cold boxes in 26new clinics after a successful 4 week trial. The trial tracked vaccines with Nexleaf Analytic'sColdTrace devices in 8 clinics that provided vaccine services to over 200,000 individuals. Thevaccines include BCG, pneumococcal vaccines, DPT+HepB/HIB, tetanus, measles, and polio. Thanksto the Medic Mobile and the Nexleaf notifications, 1200 vaccines were saved from harmfultemperatures during the trial.

HealthRight, KenyaHealthRight International is using the Medic Mobile SIM app to establish a mobile inventory monitoringsystem (MIMS) for Family Planning supplies in nine facilities. Our goal is to increase access to andavailability of family planning services at community and facility levels through improved reliability ofstock levels.

Carlos Slim Health Institute, MexicoMedic Mobile collaborated with the Carlos Slim Health Institute and Ministry of Health to create afacility-based stock monitoring program for diabetes and hypertension medications. We worked totrack drugs in 18 facilities across the country.

United Nations Foundation & One Heart World-Wide, Baglung District, NepalWe are working with One Heart World-Wide in Baglung District, Nepal by equipping 77 FemaleCommunity Health Volunteers (FCHVs) and 20 health workers with Medic Mobile for Antenatal Care(ANC). This is first time that FCHVs in Nepal have learned to use mobile technology. It was proventhat it was feasible and widely accepted, and we are in the process of scaling to 900 more FCHVsand 200 additional health workers. After comparing pre-intervention vs post-intervention data fromroutine paper reporting (HMIS) in four Village Deployment Committees (VDCs) there was a 65%increase in institutional delivery.

Amref, MalawiMedic Mobile and Amref have joined forces to implement a stock monitoring system for the MangochiDistrict of Malawi. We are working with 100 community health workers to send SMS reports to 32district pharmacies. "We need to supply the drugs in time to prevent maternal death," says MadalitsoTolani, Monitoring and Evaluation lead for Amref Health Africa Malawi. "It starts with the data. I valuedata so much. By using Medic Mobile we will identify the challenges that facilities are facing."

Christian Aid, KenyaWe're partnered with Christian Aid to improve attendance of antenatal care and immunizationappointments using Medic Mobile for SMS in Narok and Kiambu County. Community health workersacross nine clinics are using Medic Mobile for SMS to provide referrals for prenatal care for mothers,antenatal care and vaccination reminders for children.

Saving Mothers, TanzaniaMedic Mobile is working in the Mara Region of Tanzania with the Saving Mothers project, a GrandChallenges Canada project with Canadian Physicians for Aid and Relief (CPAR) and Amref Canadato support CHWs with mobile antenatal care coordination and stock monitoring for clean delivery kits.Photo courtesy of CPAR.

Living Goods, UgandaWe worked in tandem with the Living Goods team to develop dashboards for all eight of theirbranches—informed by several months of design work in Uganda. With these dashboards, BranchManagers can track which of ther agents need extra support, which customers require immediatefollow-up, and how their branch is performing. Medic Mobile is continually improving these analyticstools, working with Living Goods to deploy at more sites, and co-developing an upgraded toolkit tolaunch in 2015.

MINDS Foundation, IndiaThe MINDS Foundation is one of the few organizations that bring mental health screening andtreatment to rural areas in India. We've partnered with their team to help their community mental healthworkers (CMHW) reach more people faster. We implemented a SIM-application-based mental healthassessment tool to screen communities and identify patients who require further diagnoses and possiblemedical treatment. "Before I was doing 10 forms," says Bhavna, a CMHW, "It's much better with thephone. I do twice as many surveys."

United Methodist Communications, DRCIn partnership with the United Methodist Church and the Congolese Ministry of Health, we designedan early warning disease surveillance system. Clinicians at 45 high-risk facilities were trained to usethe Medic Mobile SIM app. The system allows health workers to report on the presence of acontagious disease, available medications for treatment and what medical staff are in place to treatpatients. If a disease outbreak threshold is exceeded, the United Methodist Communications team willimplement a messaging protocol informing community leaders in affected areas. The Medic Mobileplatform will also be used to create a two-way communication channel between the Ministry of Health(MOH) and community leaders. Photo courtesy of Neelley Hicks of UMCOM.

NewProjects

Medic Mobile is committed to developing new use cases and applying breakthroughtechnologies to improve access, adherence, and quality in the last mile of globalhealth. Our Research and Development team researches, prioritizes, designs, andrapidly tests new ideas. In 2014, we explored the following impact areas:

Performance ManagementMuso, MaliWe co-designed a Community Health Worker Performance Dashboard that provides feedback toCHWs and their supervisors on the type and frequency of services and quality of the care that CHWsprovide. Muso and Medic Mobile are conducting a randomized-controlled trial to evaluate theeffectiveness of CHW supervisors using these dashboards during monthly, one-on-one supervision visitswhere individualized coaching will be provided to each CHW.

Healthcare Access for Informal WorkersRockefeller Foundation, East Africa and South AsiaMedic Mobile was chosen by the Rockefeller Foundation as one of five partners to demonstrate theuse of human-centered design in prototyping solutions to help connect informal workers with healthservices. Our Africa and Asia Regional teams worked collaboratively in India and Uganda in order tounderstand the key concerns of informal workers. The Rockefeller Foundation will leverage our insightsand design methodology in their strategic planning around health initiatives.

Medic Mobile for Household CaregiversWe're exploring how Medic Mobile can help household caregivers directly. In India, we arepartnering with miraclefeet and their partner, CURE International, on a pilot to provide educationalmessaging via text message to families of children undergoing clubfoot treatment. The pilot is basedout of the Bai Jerbai Wadia Children's Hospital in Mumbai and focuses on long-term treatmentsupport. In Kenya, we working with KEMRI and the Wellcome Trust to study the impact of remindermessages for caregivers as they provide short-term treatment courses within their households.

Cancer CareOur team is increasingly interested in how mHealth may be deployed to support cancer care. In theearly stages of investigating whether it would be a good use case to add to the Medic Mobile toolkit,our team authored an editorial on cancer care. Our team authored an editorial published inNovember of 2014 which highlights opportunities for mobile tools to aid in cancer identification,control, and care in low resource settings. This editorial draws on historical learnings from Medic'sprojects and research in the field, literature reviews, new partner discussions, and recent design workon cancer workflows.

Research &Development

© Medic Mobile, 2014 Annual Report We are all health workers

© Medic Mobile, 2014 Annual Report We are all health workers

Our team advocates for health workers and the power of mobiletools around the globe.

Isaac Holeman speaks at TEDxBerlin

Josh Nesbit speaks at Stanford's MedX

Our team joins the first graduating class of Fast Forward, a non-profit accelerator program

Maeghan Orton presents at the first Game Changers Summit

Published in GSMA's Mobile 4 Development Impact Series

Our Product Manager, Marc Abbyad, presents Medic Mobile at the UN InfoPovertyConference

Josh Nesbit presents with SamaHope at SXSW

Our maternal and health package is featured at the US-Africa Leaders Summit

Dianna Kane, Ranju Sharma, Regina Mutuku, and Jacqueline Edwards present five abstractsand presentations at the mHealth Summit Global Health Forum

Dianna Kane and Jay Evans present at the World Cancer Congress

Dianna Kane, Marc Abbyad, and Maeghan Orton present our DIY package for the first timeat the Segal Family Foundation Annual Meeting

Dianna Kane leads first-ever health hackathon in South Africa and presents in a plenary on"Better Healthcare by Design" at the Bertha Center's Health Innovation Summit at theUniversity of Cape Town

© Medic Mobile, 2014 Annual Report We are all health workers

Spreadingthe Word

© Medic Mobile, 2014 Annual Report We are all health workers

Thanks to the generous support of our funding partners, MedicMobile is able to design new technology tools with communityhealth workers, research and prioritize new ideas, and test newdelivery models to achieve scale. Most importantly, philanthropy

allows us to focus on improving global health equity.

AshokaClif Bar & CompanyCoatue FoundationCompton FoundationDavid Weekley Family FoundationEchoing GreenEcoPhonesThe Elmo FoundationFast ForwardThe Greenbaum FoundationHaas Center for Public ServiceJill IscolJasmine Social InvestmentsThe Maternal Health Task ForceMcKesson FoundationMozilla

Mulago FoundationNancy CooleyAl and Nancy OsbornePeery FoundationPhilanthropic Ventures FoundationPopTechRita Allen FoundationSegal Family FoundationSkoll FoundationStanford Center for Innovation in Global HealthDonald A. Strauss FoundationSilicon Valley Social VenturesThe Wireless SourceUnited Nations FoundationVitol Foundation

FundingPartners

© Medic Mobile, 2014 Annual Report We are all health workers

89%

9%2%

85%

15%

View Audited Financial Statement

Financial Summary

Profit & loss statementRevenue (US$) 2014 2013

Foundations, Corporate Grants 1,702,220 1,147,617

Contracts 166,558 92,468

Other income 32,448 63,166

Contributions in-kind 14,238 17,072

Interest 44 335

Total 1,915,508 1,320,658

Expenses

Program Services 1,280,130 1,216,117

Support Services 225,238 241,893

Total 1,505,368 1,458,010

Net Income 410,140 (137,352)

2014 Revenue (%)Foundations, Corporate GrantsContractsOther IncomeContributions in-kind < 1%Interest < .01%

Balance SheetAssets 2014 2013

Current Assets 875,798 500,640

Other Assets 11,591 5,575

Total Assets: 887,389 506,886

Liabilities & Net Assets 2014 2013

Current Liabilities 337,575 367,212

Net Assets 549,814 139,674

Total Liabilities & Net Assets 887,389 506,886

2014 Expenses (%)Program ServicesSupport Services

Financials

© Medic Mobile, 2014 Annual Report We are all health workers

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